Ophthalmic orbital surgery apparatus and method and image-guided navigation system

Abstract

A flexible endoscope for ophthalmic orbital surgery includes a flexible probe housing having a proximal end, a distal end and a lumen extending between the proximal end and the distal end. The endoscope also includes an image fiber disposed in the lumen that communicates image information from the distal end of the flexible probe, a purge fluid/gas port disposed at the proximal end of the flexible probe that accepts purge fluid/gas and a purge fluid/gas conduit disposed in the lumen and in fluid communication with the purge fluid/gas port. The fluid/gas conduit delivers purge fluid/gas to the distal end of the endoscope. The endoscope also includes an access conduit disposed in the lumen that receives one of an ablation instrument, a coagulating instrument and a medication delivery instrument.

What is claimed is: 
     
         1 . A flexible endoscope for ophthalmic orbital surgery comprising:
 (a) a flexible probe housing having a proximal end, a distal end and a lumen extending between the proximal end and the distal end;   (b) an image fiber disposed in the lumen that communicates image information from the distal end of the flexible probe;   (c) a purge fluid/gas port disposed at the proximal end of the flexible probe that accepts purge fluid/gas;   (d) a purge fluid/gas conduit disposed in the lumen and in fluid communication with the purge fluid/gas port, the conduit delivering purge fluid/gas to the distal end of the endoscope; and   (e) an access conduit disposed in the lumen that receives one of an ablation instrument, a coagulating instrument and a medication delivery instrument.   
     
     
         2 . The flexible endoscope of  claim 1 , wherein the ablation instrument is a laser delivery system including:
 (i) a waveguide disposed in the lumen;   (ii) a laser source coupled to a proximal end of the waveguide; and   (iii) a lens mounted to a distal end of the waveguide nearest the distal end of the endoscope.   
     
     
         3 . The flexible endoscope of  claim 2 , wherein the laser source is one of a free electron laser source, an Argon laser source, a Dye laser source, a YAG laser source and a carbon dioxide laser source. 
     
     
         4 . The flexible endoscope of  claim 1 , wherein the ablation instrument uses one of radio-frequency waves, microwaves, ultrasonic waves, infrared waves, heat, cryoablation, and a laser to ablate the particular portion of the tissue. 
     
     
         5 . The flexible endoscope of  claim 1 , wherein the coagulating instrument uses one of radio-frequency waves, microwaves, ultrasonic waves, infrared waves, heat, cryoablation and a laser. 
     
     
         6 . The flexible endoscope of  claim 1 , wherein the medication delivery instrument is configured to apply dissolvable time release medication. 
     
     
         7 . The flexible endoscope of  claim 1 , wherein the medication delivery instrument is configured to apply radioactive seeds. 
     
     
         8 . The flexible endoscope of  claim 1 , wherein the flexible probe housing has an outer diameter of less than about 3.2 mm.